Abstract 10518: Short and Long Term Outcomes in Patients Undergoing Transulnar Coronary Angiography and Interventions - A Single Center Experience
Background - Transulnar approach has been proven to be feasible and safe alternative to transfemoral and transradial approaches for coronary angiography and interventions. However, its success rate in complex coronary interventions and its long-term safety remains to be proven.
Objectives - To evaluate the success rate of complex coronary interventions and short and long-term safety of coronary angiography using transulnar approach.
Methods - We retrospectively reviewed the medical records of patients undergoing transulnar coronary angiography and interventions at our institution from Jan 2004 through July 2009 to assess baseline clinical and procedural characteristics. Outcomes were evaluated to assess the success rate, vascular and neurological complication during index hospitalization, at 30 days and 1 year follow up from the index procedure. Major adverse cardiovascular events (MACE) were evaluated during the entire one-year follow up after the index procedure.
Results - Among 81 patients undergoing the above procedure, 48.1% were males, mean age was 67.5 years, 85.1% had diabetes mellitus and 33.3% had undergone previous coronary bypass graft surgery. Forty-one (50.6%) patients underwent interventions on 65 lesions. Twelve percent of the interventions were performed on coronary bypass grafts and 9.2% on left main coronary artery. Success rates for transulnar access, coronary angiography and coronary/bypass graft interventions were 93.8%, 100% and 92.6% respectively. Overall success rate for the procedure was 90.1%. Minor hematomas occurred in 8.6% of patients. Follow up data was available on 71 patients at short term (30 days) and 58 patients at long term (1 year). At short term follow up, one patient (1.4%) was hospitalized for a major forearm hematoma and one patient (1.4%) developed a pseudoaneurysm. At one-year follow up, there were no residual deficits from vascular or neurological complications associated with the index procedure and the MACE rate was 3.4%.
Conclusion - In this first descriptive study evaluating long-term safety and success of transulnar coronary angiography and complex coronary interventions, we conclude that transulnar approach appears to be safe and effective with relatively low MACE rate at one year.
- © 2011 by American Heart Association, Inc.